Pathology of spastic muscle in cerebral palsy.

The histopathology of muscle in cerebral palsy has not been elucidated because correlated morphologic and biochemical data on normal pediatric muscles are insufficient to allow adequate correlation of pathologic findings. One hundred and eight muscle biopsies were taken during reconstructive operations on 85 patients. Normal values for pediatric muscles were obtained from a literature review and supplemented with our data on normal patients. Fiber sizes are normally different for children of different ages. Histochemical staining of enzyme systems demonstrate that adenosine triphosphatase staining, pre-incubated at pH 9.4, 4.6, AND 4.3 WAS USED FOR FIBer typing and fiber size. Depending on the muscle biopsied and the clinical status of the patient, there is a variety of patterns of type I and type II fiber atrophy, hypertrophy, and myopathy. In some cases, denervation changes are present to suggest nerve entrapment. Correlated clinical observations suggest type I fiber predominant muscles do not re-educate well when surgically transferred to perform a specified function.